Evaluations of CDCR Substance Abuse Programs: Lessons Learned

1. Evaluations of CDCR Substance Abuse Programs:Lessons Learned Michael L. Prendergast, Ph.D. Criminal Justice Research Group UCLA Integrated Substance Abuse Programs Presented at the First Annual National Therapeutic Community Conference Denver, CO October 5-9, 2008

2. Characteristics of CDCR TC Programs • TC model adapted to prison setting • Voluntary participation is encouraged, but most admissions are mandated • Treatment occurs in the last 6 to 24 months of incarceration; 4 hours a day, plus optional activities • Treatment services are provided by agencies under contract to CDCR • Treatment clients are housed apart from the general population • Graduates can participate in community treatment

3. Continuing Care · Community treatment provided for six or more months to SAP graduates ·  Participation in community treatment is voluntary • Treatment modalities: Residential, Outpatient, Sober Living · Substance Abuse Services Coordinating Agencies (SASCAs) contract for community services and provide case management to clients • SASCAs provide transportation for many parolees to treatment programs

4. Evaluations • Amity • Forever Free • Substance Abuse Treatment Facility • Expansion Programs (16) • Female Offender Treatment and Employment Program • Valley State Prison for Women (Gender Responsive) • Database on ~28,000 treatment participants

5. Lesson 1 Prison treatment improves prison management.

6. SATF: Drug Use

7. SATF: Disciplinary Actions

8. Absenteeism among SATF and Non-Treatment Correctional Staff

9. Lesson 2 Clients need to participate in prison treatment and in community treatment (90+ days) for reductions in recidivism and drug use to occur.

10. Amity Program: 12-Month Return to Prison % Returned

11. SATF: 12-Month Return to Prison

12. SATF: 12-Month Return to Prison by Aftercare Participation

13. 100 90 80 70 60 50 % RTP 40 30 20 10 0 6-Mos 12-Mos 24-Mos 36-Mos 48-Mos None < 90 Days >90 Days Recidivism Among 2000 SATF Release Cohort by Aftercare Participation

14. Amity: Positive Drug Tests at 12-Months *** p < .0001, likelihood ratio chi square

15. SATF: Aftercare Participation by Release Cohort (N=8,037)

16. Lesson 3 SAP graduates face various barriers to enrollment in community treatment.

17. SATF: Perceptions about Aftercare • No interest in changing criminal lifestyle – found in younger prisoners • Denial of drug problem • Having a home and family to return to, so don’t need additional treatment or support • Can do it by myself (no need for additional help) • Having a home and family to return to, but worried about returning to prison

18. SATF: Barriers to Entering Aftercare • Lack of information about the programs in a prisoner’s county of commitment • Perception that family needs outweigh their need for additional treatment • Family financial strain • Few program choices in their county • Seeing aftercare as continued incarceration • Desire to start working and be productive right away • Belief that they can make it with 12-step support only

19. Lesson 4 Correctional treatment needs to be responsive to the needs of different subpopulations.

20. Life Histories of Women Offenders Compared with men offenders, women offenders: • Have more severe substance abuse histories • Have more severe histories of sexual/physical abuse • Have more severe psychological problems • Have less education • Have less employment experience and opportunities • Have less severe criminal histories • Are more likely to have custody of children

21. Forever Free Program: 12-Month Parole Performance *** 1 *** *** p<.001 1 p=.07

22. Valley State Prison for Women: Gender-Responsive Study (Preliminary Findings) Standard Prison TC Gender-Specific TC (n=29) (n=34) In aftercare at 6 months 4% 25% Reincarcerated at 6 months 48% 29%

23. Psychological Symptoms at Admission by Mental Health Status (N= 8,093)* *Bivariate Comparisons significant at p<.001.

24. 12-Month Return to Prison by Mental Health Status (N=4,408)

25. Lesson 5 Organizational factors heavily influence successful program performance.

26. Organizational Factors • Screening and assessment • Staffing • Institutional support • Lockdowns • Mission conflict • Treatment maturity

27. SATF: 12-Month Return to Prison by Amount of Aftercare and Release Cohort

28. Expansion Programs: 12-Month Return to Prison by Release Cohort

29. Lessons • Prison treatment improves prison management. • Clients need to participate in prison treatment and in community treatment (90+ days) for reductions in recidivism and drug use to occur. • SAP graduates face personal and institutional barriers to enrollment in community treatment. • Correctional treatment needs to be responsive to the needs of different subpopulations [women, co- disordered]. • Organizational factors heavily influence successful program performance [include maturity].

30. Thank you Questions? www.uclaisap.org > Presentations Supported by: CDCR Contracts C94.217, C97.243, C97.355, C98.346, C02.017, C06.229,C06.082 NIDA Grants R01DA11483, R21DA018699 NIJ Grants 97-RT-VX-K003, 1999-RT-VX-K003